Miyofasiyal Ağrılı Hastalarda Botulinum Toksin-A Enjeksiyonunun Yaşam Kalitesi Üzerindeki Etkilerinin Değerlendirilmesi

Amaç Bu çalışmanın amacı, temporomandibular miyofasiyal ağrısı olan hastalarda, botulinum toksin-A (BTX-A) enjeksiyonunun kronik ağrı üzerindeki etkisi ile birlikte yaşam kalitesindeki iyileşmeyi değerlendirmekti. Materyal-Metot Çalışmaya Temporomandibular Düzensizlikler İçin Tanı Kriterleri’ne göre yalnızca miyofasiyal ağrı tanısı alan 76 hasta çalışmaya dahil edildi. Tüm hastalarda Massater ve Temporal kaslara sırasıyla tek tarafa 30U/0.6mL ve 20U/0.4mL olmak üzere bilateral olarak BTX-A enjeksiyonu yapıldı. BTX-A enjeksiyonunun myofasiyal ağrılı hastaların yaşam kalitesi üzerindeki etkisi, OHIP-TMDs anketi kullanılarak ölçüldü. Hastalar enjeksiyondan önce, ve enjeksiyondan 6 ay sonra hem anketlere hem de ağrı düzeyinin değerlendirmesinde kullanılan görsel analog skalaya cevap verdiler. Yaşam kalitesindeki değişim ile yaş, cinsiyet, eğitim düzeyi ve iş yaşantısı gibi faktörler arasındaki ilişkiler değerlendirildi. Bulgular BTX-A enjeksiyonlarından 6 ay sonra cinsiyet, yaş, eğitim düzeyi ve istihdam durumu farkı gözetmeksizin OHIP-TMDs ve VAS skorlarında iyileşme yönünde istatistiksel olarak anlamlı fark kaydedildi (p≤0,05). BTX-A enjeksiyonu öncesi ve sonrasında, hastaların dereceleme türü tepki kategorileri ile anket sorularını cevaplayarak bireysel yaşam kalitesinin raporlayabilme kabiliyeti ile eğitim düzeyi ve iş yaşantısı arasında anlamlı pozitif korelasyon kaydedildi (p≤0,05). Hastaların eğitim düzeyinin artması ve iş yaşamına sahip olunması ile BTX-A enjeksiyonu sonrası daha yüksek yaşam kalite skorları arasında istatistiksel olarak anlamlı ilişki gözlendi (p≤0,05). Sonuç Miyofasiyal ağrı sendromu hastalarında ağrı düzeyi ve yaşam kalitesinde BTX-A enjeksiyonlarından 6 ay sonra anlamlı düzeyde iyileşme kaydedildi. Bu tedavi şekli, yaşam kalitesinde ve klinik parametrelerde iyileşme sağlaması ile hastalar için umut vericidir.

Anahtar Kelimeler:

Fasiyal ağrı, Temporomandibular Eklem Bozuklukları, Botulinum Toksinler A Tipi, Yaşam Kalitesi

The Effect of BotulinumToxin-A Injections on the Quality of Life of Patients with Myofacial Pain

Objective The aim of this study was to evaluate the impact of botulinum toxin type A (BTX-A) injections on chronic pain and quality of life of patients with temporomandibular myofacial pain. Material-Method This study was carried out on 76 individuals presenting with clinically myofacial pain according to The Diagnostic Criteria for Temporomandibular Disorders. All patients were injected with 30 U of BTX-A for the masseter muscle per side and 20U of BTX-A for the temporal muscle per side. A 10-cm visual analog scale and OHIP-TMDs questionnaire were used to assess pain severity and quality of life in patients with myofacial pain respectively before and six months after BTX-A injections. Changes in quality of life and pain severity were corralated with age, gender, education level and employment status. Results A statistically significant improvement in pain and OHIP-TMDs scores were found six months after BTX-A injections, regardless of gender, age, education level and employment status (p≤0.05). A significant positive correlation was observed between patients’ self-reporting capability when answering questions on self-rated quality of life and education level and/or employment before and after BTX-A injections (p≤0.05). Higher educational levels and/or employment status were found to be related with higher OHIP-TMD scores after treatment (p≤0.05). Conclusion Patients with myofacial pain presented significant improvements in pain and quality of life scores 6 months after BTX-A injections. This form of therapy seem promising for patients to provide improvement in quality of life and as well as clinical parameters.

Keywords:

Facial Pain, Temporomandibular Joint Disorders, Botulinum Toxins Type A, Quality of Life,

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